Eleanor Golling1,2, Nigel Barr3, Thea van de Mortel2, Peta-Anne Zimmerman2
1St John WA, Belmont, WA, Australia
2Griffith University Queensland, Australia
3University of Sunshine Coast Queensland, Australia
Introduction
Peripheral venous catheter (PIVC) insertion is commonly undertaken by paramedics for the anticipated or immediate administration of intravenous medications and fluids. International studies report a wide variance in unused PIVC rates, however no large-scale studies have been undertaken on unused paramedic PIVCs in Australia. The study aim was to investigate rates of unused paramedic-inserted PIVCs in an Australian jurisdiction, and the factors that influenced usage.
Methods
A retrospective review of electronic patient care records (ePCRs) of all patients attended to by the Western Australian ambulance service in 2020 was conducted. Data for 11 variables were collected, and grouped into patient, environmental, and paramedic characteristics. Logistical regression models identified influencing factors for unused PIVCs.
Results
A total of 187,585 ePCRs were included. Patient median age was 61 years and 50.6% were female. The insertion success rate was 82.3%; 81.2% were inserted at the first attempt. The most common insertion site was right cubital fossa. Forty-four percent (n = 16,792) of PIVCs inserted remained unused for the paramedic episode of care. Factors associated with unused PIVCs were older age, chief complaint, and paramedic years of experience.
Conclusion
This is the first Australian state-wide study to report on rates of unused paramedic PIVCs. Nearly half remained unused for the paramedic episode of care suggesting many PIVC insertions may not be clinically indicated and are unnecessary. Targeted interventions focused on improved PIVC training and education, mentoring of junior paramedics, and clinical decision-making guidelines should be investigated to reduce unnecessary PIVC insertions.
Biography
Ellie is a Registered Nurse with a background in critical care, prior to specialising in infection prevention and control. She has a strong interest in implementing pragmatic and sustainable IPC programs in non-hospital-based settings and has worked in this field in residential aged care, community care, and in the quarantine hotels during the pandemic. She is currently the state-wide IPC Specialist for the jurisdictional ambulance service in Western Australia. Ellie has completed her Master of Infection Prevention and Control with Griffith University.